title: Nutrition changes in conservatively treated patients with encapsulating peritoneal sclerosis.
abstract: BACKGROUND
  Encapsulating peritoneal sclerosis (EPS), a rare but serious complication of long-term PD, is characterized by nausea, abdominal pain, weight loss, anorexia, and constipation. It can cause a significant deterioration in a patient's nutrition status. In the present study we examined changes in nutrition status and outcomes for patients with EPS treated conservatively without the use of surgical intervention.
  
  
  METHODS
  Patients diagnosed with EPS at our institution between December 2006 and December 2010 were identified, and data on demographics, nutrition, and symptoms were collected every 2 months for 12 months and then at 18 and 24 months.
  
  
  RESULTS
  Of the 15 patients identified, 12 were malnourished or at risk of malnutrition according to their subjective global assessment score, with 11 of the 15 presenting with more than 10% weight loss in the 6 months before diagnosis. Furthermore, symptom burden was high, with 11 of 15 patients reporting 2 or more gastrointestinal symptoms. Of the 15 patients, 12 required parenteral nutrition for a median of 4.5 months, and 5 died within the first 12 months after diagnosis. In the 10 survivors, albumin and C-reactive protein significantly improved over the 24 months after diagnosis. Improving trends in weight and symptoms were also observed in those patients.
  
  
  CONCLUSIONS
  In some patients with EPS, a conservative approach without surgical intervention, and with regular dietetic input and aggressive nutrition support, can lead to improved nutrition status and symptoms.
authors.affiliation: Department of Nutrition and Dietetics1 and Imperial College Kidney and Transplant Centre,2 Hammersmith Hospital, London, UK.
authors.forename: Nevine
authors.initials: N
authors.lastname: El-Sherbini
authors.forename: Neill
authors.initials: N
authors.lastname: Duncan
authors.forename: Mary
authors.initials: M
authors.lastname: Hickson
authors.forename: Lina
authors.initials: L
authors.lastname: Johansson
authors.forename: Edwina A
authors.initials: EA
authors.lastname: Brown
mesh_terms: D001835:Body Weight; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000628:therapy; D008297:Male; D044342:Malnutrition / Q000201:enzymology / Q000209:etiology* / Q000628:therapy; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D010288:Parenteral Nutrition / Q000379:methods*; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D056627:Peritoneal Fibrosis / Q000150:complications / Q000201:enzymology / Q000628:therapy*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
keywords: Encapsulating peritoneal sclerosis; nutrition status; total parenteral nutrition